Bianca Jordaan on ‘Change Management for Clinical Programs’

Bianca Jordaan, Change and Adoption Manager for the eMR Connect Program at eHealth NSW talks about the approach to Change Management being used to implement and optimise use of the electronic medical record (eMR), including eMeds, across NSW Health.

Bianca will be speaking to the eMedication Management Conference on Wednesday 15 March 2017 on Driving Change across Major Clinical Programs.

What is eMR Connect’s overarching approach to change management?

For us, change is all about helping people to understand what the eMR will mean for them and to feel supported and equipped to use it – and use it well.

To help local teams manage this change, we focus on four key things:

Demystifyingchange management with the help of our Change Management Framework, which also has tools and templates that project teams can adapt for their own needs

Providing coaching to the local change managers

Driving continuous learning and improvement based on what we observe across all sites

Ensuring there is budget allocated for change resources at both the state and hospital level

What are some ways in which eHealth NSW is enabling the sustainable and seamless transition of eHealth programs to ‘Business as Usual’ (BAU)?

This is a big focus for us. We’re working hard to get the right connections between project teams and BAU teams, including up-skilling the BAU teams to support a seamless transition.

The day of ‘go live’ is just the beginning. It’s good to see more Local Health District (LHD) project teams looking past the go live period and continuing to be engaged to ensure the new practices are being applied and, where needed, providing extra support and training.

As the eMR is reaching critical mass, people are also beginning to understand that few clinical changes can be considered without understanding how they affect the eMR. So, BAU is everyone’s business.

What is the level of ‘change fatigue’ on the frontline of healthcare and how are we dealing with this?

There is a degree of ‘change fatigue’ but, more encouragingly, we’re now at a point in rolling out eHealth technologies where end users can start seeing the rewards. We’re giving clinicians electronic tools they can use to support patient care, not just capture data.

We’re also learning to support clinicians better through the critical point of ‘go live’; while this can be a difficult period, we’re now hearing positive feedback after an eMR implementation.

I actually think we’re reaching a point of ‘change hunger’. When people start using the eMR in day-to-day practice, they want more functionality, they want better functionality and they expect it to work like the systems they use in their personal lives. So, we’re getting to an exciting time.

How hard and therefore important is it to embed digital literacy in this approach?

I’d first make a distinction between computer literacy and digital literacy.

Back when the first eMRs were rolled out, many frontline staff would not have used a computer on a daily basis. The evolution of smart devices has changed this, along with generational change in our workforce. Now with more than 135 hospitals and 330 community facilities using the eMR, computer literacy levels are higher and are also supported as needed in the workplace.

I think digital literacy is the challenge now. When we ask a user what they’d like the system to do for them, they talk about their needs based on their current way of working – that is, filling in forms. With the new technologies, we need to move beyond this realm of thinking. Just like someone in the 1950s who had to go to a bank branch to withdraw or deposit money wouldn’t have been able to envisage moving money around the world at any time of the day from the comfort of a chair using their phone – and that same phone being pocket-sized, wireless and a camera.

In the same way, our challenge is to envisage where eHealth may take clinical care in the next 40 years – we need to start thinking differently about the eMR and what it might do.

How are e‑literacy initiatives being targeted towards all stakeholders in the health system, including patients, families and carers?

When the eMR is rolled out at sites, engagement with patients, families and cares is an important element of our communication plans – we need to ensure people are comfortable with how and why their personal clinical information is being captured. Anecdotally, the on-site teams tell us that patients ‘get it’, and are very accepting of computers on wheel or other devices being used at the bedside.

Our stakeholders live and work in a digital world. When I said our clinicians are starting to expect the eMR to work like the systems they use in their personal lives, the same goes for our patients and their families and carers. We need to be continually closing the gap to meet those expectations. Certainly, the eHealth Strategy for NSW Health is drawing together all the elements and striving to address that.

*This article first appeared in eHealth News, November / December 2016 edition.